Question: Are Physician Extenders Filling in the Physician Shortage Gaps?

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pa-thumb1Many healthcare organizations are well-versed in the ongoing conflict between physician extenders and physicians over expanded authority for nurse practitioners and physician assistants. Physician extenders claim that allowing them more independence in caring for patients will help meet the challenges posed by the worsening physician-shortage crisis.

According to Maggie Fox of NBC News, this is exactly what is happening, especially in the face of a projected shortage of 90,000 physicians by 2020. She writes that PAs and NPs across the country are now “providing tests, counseling, and other basic care when a doctor is unavailable.”

Carrie Kowalski is one example of a physician assistant who is going into regions desperate for medical care. Her organization, Venice Family Clinic, “sends Kowalski in a van to scour the streets of the southern California city, finding the homeless and near-homeless who need help. Kowalski and her team provide basic care, tending to injuries, testing and counseling for HIV, and trying to persuade patients to come in for more comprehensive care.”

With implementation of the Affordable Care Act fully underway, Kowalski foresees an incredibly busy future for physician extenders: “It really will be remarkable the impact the Affordable Care Act will have on our clients, because a lot of them so far haven’t qualified for Medicaid because they are single. So a great majority of them will now be able to get Medicaid, which will help us a lot — not only because the family clinic where I work will be paid to see these patients that we [are] already seeing, but we’ll be able to get them to the specialists they need.”

“More than 7,000 newly accredited physician assistants graduate each year and go on to write prescriptions, manage patients with both immediate needs such as injuries and chronic disease such as diabetes, perform minor surgery, and coordinate care,” Fox reports, and incredibly, since 2006, the number of physician assistants in the United States has increased by a third, according to the American Academy of Physician Assistants.

Lawrence Herman, AAPA president, said, “Currently, there are more than 93,000 PAs throughout the U.S. whose education in general medicine prepares them to be extremely nimble, positioning them very well to address an influx of 20 million new patients entering the healthcare system.”

As healthcare executives, how integral are physician extenders to your healthcare community? How do they ease the burden on your physicians and your medical staff in general? Do you think that their authority to provide care should be expanded?

-by Pete Fernbaugh

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